Systematic review of the status of pfhrp2 and pfhrp3 gene deletion, approaches and methods used for its estimation and reporting in Plasmodium falciparum populations in Africa: review of published studies 2010–2019

Malaria Journal

Joan N. Kalyango¹  Charles Karamagi¹  Chae Seung Lim²  Emmanuel Arinaitwe³  Jimmy Opigo⁴  Sam Nsobya⁵  Joaniter Nankabirwa⁶  Bosco B. Agaba⁷  Moses R. Kamya⁸  Adoke Yeka⁹  Paul Mbaka^1,10 

[1] Clinical Epidemiology Unit, Makerere University Kampala, Kampala, Uganda;Department of Laboratory Medicine, College of Health Sciences, Korea University, Seoul, South Korea;Infectious Diseases Research Collaboration, Kampala, Uganda;National Malaria Control Programme, Kampala, Uganda;School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda;School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda;Clinical Epidemiology Unit, Makerere University Kampala, Kampala, Uganda;Infectious Diseases Research Collaboration, Kampala, Uganda;School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda;Clinical Epidemiology Unit, Makerere University Kampala, Kampala, Uganda;National Malaria Control Programme, Kampala, Uganda;School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda;Infectious Diseases Research Collaboration, Kampala, Uganda;School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda;World Health Organization Country Office, Kampala, Uganda;

关键词: Malaria rapid diagnostic tests;    Plasmodium falciparum;    Histidine rich protein 2 gene;    Systematic review;    Histidine rich protein 3;    Gene deletion;    Africa;   

DOI  :  10.1186/s12936-019-2987-4

来源: Springer

【 摘 要 】

BackgroundMalaria rapid diagnostic tests based on histidine-rich protein-2 have played a vital role in improving malaria case management and surveillance particularly in Africa, where Plasmodium falciparum is predominant. However, their usefulness has been threatened by the emergence of gene deletion on P. falciparum histidine rich protein 2 (pfhrp2) and P. falciparum histidine rich protein 3 (pfhrp3). Use of standard and recommended methods is key for accurate investigation, confirmation and reporting of pfhrp2 and pfhrp3 gene deletion.MethodsA systematic review was conducted to assess the status, methods and approaches that have been used for investigation, confirmation and reporting of pfhrp2 and pfhrp3 gene deletion in Africa. An online search was done using PubMed and MEDLINE Google Scholar for all articles published in English on pfhrp2/3 gene deletion in Africa. Relevant articles that met the inclusion criteria were summarized and assessed based on the protocol recommended by the World Health Organization for confirmation and reporting of pfhrp2/3 gene deletion.ResultsThe search identified a total of 18 articles out of which 14 (77.7%) fulfilled the criteria for inclusion and were retained for review. The articles were distributed across 12 countries where the pfhrp2 and pfhrp3 gene deletion studies were conducted and reported. The level of pfhrp2/3 gene deletion across selected studies in Africa ranged from the highest 62% to the lowest 0.4%. There was wide variation in methods and approaches including study designs, size and sampling and whether both pfhrp2 and pfhrp3 double deletions or pfhrp2 single deletion were investigated, with a wide variation in laboratory methods.ConclusionBased on the review, there is evidence of the presence of pfhrp2/3 gene-deleted P. falciparum parasites in Africa. The approaches and methods used for investigation, confirmation and reporting of pfhrp2/3 deleted parasites have varied between studies and across countries. Countries that are considering plans to investigate, confirm and report pfhrp2/3 deletion should use recommended standard and harmonized methods to prevent unnecessary recommendations for costly switch of RDTs in Africa.

【 授权许可】

CC BY